House Officer

You've gotten a call from the nurses about a patient's study - does the patient need to be NPO? Can you clarify if they need contrast (PO or IV)?
Hopefully, you'll find some answers here...

Cardiac
P. thal:

1. NPO after midnight (diabetics may have a light meal, only if needed)
2. No foods with caffeine for 12 hours prior to exam (if abnormal creatinine, caffeine needs to be held at least 24 hours prior to exam) - includes "DECAF" beverages (coffee, tea, cola, etc.)
3. No nitrates 24 hours prior to exam (no nitroPASTE within 48 hours prior to exam) - except sublingual or spray nitrates
4. No aminophylline 24 hours prior to exam (this is the antidote to persantine)
5. Hold hypoblycemic/insuln meds
6. For resting portion: No caffeine or nicotine

Treadmill Stress Test:

1. No beta-blockers for 24 hours prior to exam (remember, the goal is to see an increase in heart rate while on the treadmill)
2. May give short-acting beta-blockers up to 12 hours prior to this test
3. If your patient has ST-depression in the lateral leads secondary to repolarization from LVH, your patient buys themselves a stress ECHO - run this by your attending

Stress ECHO: